Provider Demographics
NPI:1477832400
Name:SYMINGTON, MELISSA FOX (PHD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:FOX
Last Name:SYMINGTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E DEL MAR BLVD STE 126
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-2551
Mailing Address - Country:US
Mailing Address - Phone:626-449-2525
Mailing Address - Fax:626-564-1250
Practice Address - Street 1:200 E DEL MAR BLVD STE 126
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2551
Practice Address - Country:US
Practice Address - Phone:626-449-2525
Practice Address - Fax:626-564-1250
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-08
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSB34429103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist